Radiology is a branch of medicine in which various imaging techniques may be employed to diagnose and treat a wide variety of diseases. Named for the radioactive substances used to produce the images, radiologists, also known as clinical radiologists, may employ many techniques for imaging the patient, including magnetic resonance imaging (MRI), computed tomography (CT, or “cat scan”), ultrasonography (US), nuclear medicine (NM), x-ray/plain film, angiography, and fluoroscopy, to name a few. In addition to their medical education, radiologists receive training in reading and interpreting radiographic images.
To facilitate diagnosis and treatment, a patient's physician, such as a general practitioner, may order one or more radiology tests on the patient. A radiology technologist positions the patient before the imaging apparatus and initiates the imaging function, which produces the radiographic image. Rarely, the patient's physician is capable of interpreting the radiographic image. In many environments, such as hospitals and group practices, the task of interpreting the image is left to the radiologist.
With such division of labor prevalent in medicine, the patient is rarely in communication with the radiologist directly. Thus, before interpreting the radiologist images, the radiologist may prefer or require additional patient information from the physician, such as historical information, known symptoms, and other communication obtained by the patient's physician. Once the radiographic image and the additional patient information are received, the radiologist produces one or more reports. The patient physician is able to diagnose and treat the patient, in large part, based upon the report(s).
Radiographic images are ordered in the diagnosis of a number of different patient maladies. While the patient with a common cold may avoid being imaged, patients with broken bones, pregnant women, and cancer patients routinely obtain radiographic images prior to diagnosis or during treatment. The successful operation of a medical facility, such as a hospital or group practice, therefore, depends on the availability of one or more radiologists at all times and the efficient interpretation of radiographic images by the radiologist.
The availability of radiologists and radiology services during weekends and after-hours (e.g. 5:00 p.m.-7:00 a.m.) may be particularly problematic, as many facilities do not have a radiologist present during these hours. Further, many physicians may not have radiology equipment (even x-ray machines) on-site, and may thus send the patient to a radiology laboratory to obtain the images, which are then returned to the diagnosing physician. The delays associated with these conditions may impair the ability of the diagnosing physician to successfully and timely treat the patient.
In the past, radiology clinics principally employed printed film to capture the radiographic image, which the radiologist then physically hung on “view boxes” to illuminate the image. Today, many of the radiographic images generated using the techniques enumerated above may be stored digitally and viewed on computer displays.
Once the radiographic image has been generated, the radiologist conducts a study of the radiographic image, usually, by dictation. One common mechanism used by radiologists dictating radiographic images is known as PowerScribe. (PowerScribe is a product of Nuance Dictaphone Healthcare Solutions of Burlington, Mass.) Where PowerScribe is used, the radiologist would dictate the study by talking into a PowerScribe handset. The radiologist's voice is changed into text, which is then automatically displayed on a video monitor. The study is now ready for the clinician to review.
The clinician reads through the report(s) and selects the radiographic images (there may be several), such as by clicking them with a mouse on the video monitor. If the clinician wants to review the study with a radiologist, the clinician usually calls or sends electronic mail to the radiologist, thus resulting in a delay to completion of the clinician's job. Alternatively, the radiologist may desire a personal interaction with the clinician on the study, such as where new ground is covered. In either case, completion of the study is impaired, due to the different schedules between the radiologist and the clinician, the availability of either party during the other's schedule, and so on.
The coordination issues are compounded when there are multiple clinicians who need to interpret the study. Further, the doctor who originated the study may desire to communicate further with the radiologist. The radiologist may have communicated with one party about the study, only to have to repeat the communication with another party. There may be complicated or learning cases where it would be useful to have the expert radiologist who read the case give a brief video demonstration rather than having to dig through the report to find the images. If the dictating radiologist is not available, a different radiologist (who is likely to be unfamiliar with the case) must start anew, interpret the case, compare his findings to the original reader, and then explain the case to the interested clinician.
Thus, there is a continuing need for a mechanism by which a radiographic study may be repeatedly communicable to multiple parties on an as needed basis.